摘要
目的分析宫腔镜检查对不孕症与复发性流产患者宫腔病变性质的诊断价值。方法回顾性分析我院2014年3月-2018年1月收治的269例不孕症患者(原发性不孕120例、继发性不孕149例)和141例复发性流产患者的临床资料,均有完整宫腔镜及病理诊断结果,分析宫腔镜对此类患者宫腔病变的诊断价值,并比较不孕症与复发性流产患者宫腔病变性质。结果经宫腔镜检查,277例正常,其余133例(32.44%)存在宫腔病变,以宫腔粘连比重最高,其次为子宫内膜息肉;三组经宫腔镜检查提示正常患者比重分别占69.17%、77.18%、56.03%;而经宫腔镜检出的宫腔病变类型中,原发性不孕患者以子宫内膜息肉、子宫内膜炎比重最高;继发性不孕、复发性流行均以宫腔粘连比重最高,且存在宫腔病变的复发性流产患者中,子宫畸形亦占一定比重(7.80%);且三组宫腔镜检查正常比例、宫腔粘连检出率、子宫内膜息肉检出率比较差异有统计学意义(P<0.05);其中继发性不孕组宫腔镜检查正常比例显著高于复发性流产组,原发性不孕及继发性不孕组子宫粘连检出率显著低于复发性流产组,而原发性不孕组子宫内膜息内检出率显著高于继发性不孕组、复发性流产组(P均<0.05);同时,仅1例宫腔镜检查后出血,发生率O.24%。结论不孕症与复发性流产患者宫腔病变类型或存在一定差异,宫腔镜对不孕症与复发性流产患者官腔病变进行诊断分析可为其临床诊治提供参考意见,值得临床重视。
Objective To analyze the value of hysteroscopy in diagnosis of the nature of uterine cavity lesions in patients with infertility and recurrent spontaneous abortion.Methods The clinical data of 269patients with infertility (120cases of primary infertility,149cases of secondary infertility)and 141patients with recurrent spontaneous abortion who were admitted to the hospital during the period from March 2014to January 2018were retrospectively analyzed.The results of hysteroscopy and pathological diagnosis were complete.The diagnostic value of hysteroscopy for uterine lesions in such patients was analyzed,and the nature of uterine lesions in patients with infertility and recurrent spontaneous abortion was compared.Results Examined by hysteroscopy,277cases were normal,the remaining 133(32.44%)had uterine lesions,with the highest proportion of intrauterine adhesions,followed by endometrial polyps.The proportions of three groups of normal patients showed by the proportions were 69.17%,77.18%,56.03%;among thetype of uterine lesions detected by hysteroscopy,the proportion of endometrial polyps and endometritis in primary infertility patients were the highest;secondary infertility and recurrent spontaneous abortion also had the highest proportion with intrauterine adhesion.Among the recurrent abortion patients with uterine lesions,uterine malformation accounted for a certain proportion (7.80%},the difference in the rate of normal situation,intrauterine adhesions detection,endometrial polyps by the cervical mirror in the three groups was statistically significant (P<0.05);and the normal proportion of hysteroscopy in the recurrent infertility group was significantly higher than that in the recurrent abortion group.The detection rate of primary infertility and secondary infertility group was significantly lower than that of the recurrent abortion group,the detection rate of endometrial polyps in the primary infertility group was significantly higher than that in the secondary infertility group and the recurrent abortion group (P<0.05).At the same time,only 1hemorrhage after hysteroscopy,the incidence rate was 0.24%.Conclusion There are some differences between barrenness and the types of uterine lesions in patients with recurrent abortion.The diagnosis and analysis of the uterine lesions in patient with infertility and recurrent spontaneous abortion based on cervical mirror can provide reference for clinical diagnosis and treatment, which deserves clinical attention.
作者
安晓霞
刘晨
An Xiaoxia;Liu Chen(Department of Gynecology and Obstetrics,Armed Police Beij ing General Hospital,Beijing 100027,China)
出处
《中国煤炭工业医学杂志》
2018年第6期625-629,共5页
Chinese Journal of Coal Industry Medicine
基金
北京市科技局资助项目(编号:H010910150119)
